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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Muscular Pain While Suffering From Rheumatoid Arthritis Be Treated?

Hi my cardiologist had increased the dosage from 10 mg of cilacar to 20 mg cilacar , Eptus T 10/25 in place of Tide 5 mg along with Cardivas 12.5 + 6.25mg and clopilet A 75 mg. I had undergone CABG ( triple vessel block) 5 grafting in February 2011. My recent 2D color Doppler Echogram shows EF 35 % FS16% and impression : Global hypokinesiaof LV with accentuated hypo kinesiology thinning of inferoposterior segments Dilated LV / moderately severe LV dysfunction / No LV clot / stroke volume61ml. Cardiac output 3.77 L/min. / 2+ mitral regurgitation 2+ both Aortic Tricuspid regurgitation / mild to moderate Pulmonaryartery hypertension/ RA ,RV normal in size and adequate RV function no PE. Will you please as to whether the modified drugs and the dosage are essentially required as I am comfortable with earlier dosage of medicines. I already have muscle weakness and muscular pain and my diabetes levels gone up but now brought to control with antidiabetic drug metformin + glitizide and 10 - 12 units of humalog in the morning and Lantus 100 in the night. Looking forward to your expert medical opinion and guidance.
Tue, 16 Oct 2018
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Internal Medicine Specialist 's  Response
Hi,

You are having HFrEF. Stop all oral diabetic drugs (OHA). Only take insulin as these drugs are contraindicated in renal and heart failure. You have adequate 2D LVEF for daily activities. Your drugs are also good according to recent guidelines of heart failure.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Anshul Gupta,
Internal Medicine Specialist
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How Can Muscular Pain While Suffering From Rheumatoid Arthritis Be Treated?

Hi, You are having HFrEF. Stop all oral diabetic drugs (OHA). Only take insulin as these drugs are contraindicated in renal and heart failure. You have adequate 2D LVEF for daily activities. Your drugs are also good according to recent guidelines of heart failure. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anshul Gupta, Internal Medicine Specialist